WEST ORANGE – As the fall season approaches, millions of student-athletes are preparing to take to the playing fields – and with that comes an increased risk of sports-related injuries. According to the Centers for Disease Control (CDC), more than seven million students participate in high school sports annually and millions more are active on the elementary and middle school levels as well as in recreation leagues. High school athletes alone account for an estimated two million injuries, 500,000 doctor visits, and 30,000 hospitalizations with the highest injury rate among football players, followed by wrestlers and soccer players. In addition, more than 3.5 million children ages 14 years and younger receive medical treatment for sports-related injuries.

“Sprains, muscle strains, bone or growth plate injuries, fractures, and overuse or repetitive motion injuries, as well as heat-related illnesses, are the more typical injuries among children,” explained Neil N. Jasey, M.D., Director of Brain Injury Rehabilitation at Kessler Institute for Rehabilitation. “However, concussion, or mild traumatic brain injury (mTBI), is increasingly one of the most common sports-related injuries. It is also one of the most difficult to diagnose – and one of the most serious because of the long-term cognitive and behavioral problems it can cause.”

The CDC estimates that more than 300,000 children sustain a concussion while participating in sports-related activities each year, with similar numbers occurring during practice as in games. “It’s critically important that players, coaches and parents are aware of the symptoms, know when to seek medical attention and understand the need for appropriate return-to-play strategies,” said Dr. Jasey. “It’s also essential for players to undergo baseline cognitive testing as part of a pre-season physical.”

Kessler Institute for Rehabilitation, one of only five federally designated Model Systems for the treatment and research of both traumatic brain  (http://kessler-rehab.com/programs/brain-injury-rehab) and spinal cord injuries (http://kessler-rehab.com/programs/spinal-cord-injury-rehab/Default.aspx) in the nation, offers the following sports guidelines for athletes, parents, and coaches:

  • Ace the exam. Every player should undergo a complete physical before engaging in any sports activities. In addition, a cognitive assessment, such as ImPACT testing, should be performed. This important tool, which is increasingly being used at both the professional and school-age levels, helps to establish a baseline reference that can be helpful in diagnosing the extent of any brain injury.
  • Get equipped. Athletes should wear appropriate footwear and sport-specific safety gear such as helmets, mouth guards and other protective equipment, all of which should be carefully fitted. Equipment should also be checked regularly to ensure that it is good condition and still fitting properly.
  • Be prepared. Adequate training and conditioning is imperative before participating in any sport, to increase muscle strength, flexibility and aerobic fitness. Training, practice and pre-game sessions should always include warm-up and cool-down exercises.
  • Stay hydrated. At all times, and particularly in hot, humid weather, athletes should drink plenty of fluids before, during and after training, practices and games.
  • Listen up. Coaches and trainers should enforce the rules, encourage safe play, understand the risks and be certified in first aid and CPR.
  • Pay attention. Young athletes need to be aware of injury symptoms and encouraged to speak up about any pain, dizziness or other issues that they may experience. Similarly, parents, teachers and coaches should be vigilant – looking out for any signs of injury, including nausea/vomiting, dizziness, confusion, limping or anything out of the ordinary.
  • Seek medical help. Depending on the nature and severity of an injury, an athlete should seek immediate evaluation and/or treatment by a physician or other health care professional or be taken to the emergency room.

An athlete suspected of sustaining a concussion (mTBI) should be removed from the game immediately and examined by a trained professional. Coaches, trainers, parents and players should be on the lookout for symptoms including dizziness, confusion, loss of balance, headache, nausea and/or vomiting and extreme fatigue. Other symptoms that may develop over time include irritability, difficulty with memory or concentration, impaired judgment, behavioral issues, personality changes and even depression, as well as changes in schoolwork and academic performance.

Dr. Jasey also suggests the following concussion-specific strategies:

  • Any athlete who experiences loss of consciousness, even if just for a few seconds, should be taken to the emergency room immediately for a thorough neurological evaluation. Unlike physical injuries, such as a sprain or broken bone, the signs of brain injury may not present themselves immediately.
  • While there are no clear-cut guidelines for return to play, rest is critical. It takes time for the brain to recover and the athlete should limit physical activities and continue to be observed for several days. Studies show that more than 40% of athletes who experience a concussion return to play too soon. Adequate “cognitive” rest is also important, so television, video games and certain schoolwork should be kept to a minimum.

“Most young athletes recover from sports-related injuries, including concussion, providing they are recognized early and treated carefully,” added Dr. Jasey. “Immediate medical attention and appropriate treatment are necessary in order to avoid complications. While coaches, trainers, family members and players need to be aware of the risks and symptoms, athletes also need to be honest about any problems they are experiencing. Too often we see players disregard their symptoms, tough it out and return to play too soon in an attempt to keep their competitive edge, which can result in serious complications and lasting problems.”

DID YOU KNOW? (Source: Centers for Disease Control (CDC); Safe Kids USA)

  • Almost two-thirds (62%) of sports-related injuries occur during practice, rather than in games.
  • Contact or collision sports generally have higher rates of injury, but injuries from individual sports tend to be more severe.
  • Sports and recreational activities account for about 21% of all traumatic brain injuries among American children.
  • Girls have a higher incidence of concussion than boys, particularly in basketball and soccer.
  • Cycling accounts for nearly 25% of all sports-related brain injuries. Baseball and football each account for 14%, followed by basketball (11%), water sports (8%) and soccer (7%).
  • Once an athlete experiences a concussion, he or she is four to six times more likely to sustain a second concussion.
  • More than 40% of athletes who experience a concussion return to play too soon.